Der Internist
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Myocardial ischemia is triggered by a mismatch between the oxygen supply and demand of the myocardial tissue. The most common cause is coronary artery disease; however, not every coronary stenosis is hemodynamically relevant and leads to myocardial ischemia. ⋯ Cardiac computed tomography, stress echocardiography, nuclear cardiological procedures (positron emission tomography and single photon emission computed tomography) and cardiac magnetic resonance imaging are the main diagnostic tools for this purpose and are incorporated into the clinical routine. This article provides a review of the indications, the relative advantages and disadvantages of the respective methods and their utilization in routine clinical practice.
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Review Case Reports
[Multicentric Castleman's disease combined with polyserositis and POEMS syndrome: case report and review article].
Castleman disease (CD) is a very rare disorder characterised by hyperplasia of the lymphoid tissue. The aetiology varies considerably and includes autoimmunological, infectious, autoinflammatory and paraneoplastic diseases (e.g. MGUS with POEMS syndrome). ⋯ The sum of these changes sometimes causes very heterogeneous symptoms and thus often makes early diagnosis difficult. The prognosis of unrecognised and untreated disease is very serious and has an average 5‑year survival rate of 55-77%. The present paper describes the case of a 79-year-old patient with refractory polyserositis who was correctly diagnosed after > 8 years.
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Case Reports
[Treatment-refractory anaemia in a 35-year-old heart transplant recipient on chronic hemodialysis].
This article presents a case of pure red cell aplasia in a 35-year-old heart transplant recipient on chronic hemodialysis. Elevated parvovirus B19 immunoglobulin M blood levels were detected along with a high viral load of 80 billion IU/ml quantified by polymerase chain reaction. ⋯ Anaemia had significantly improved 4 weeks later. Parvovirus B19 infection should be excluded in organ transplant recipients with anaemia due to ineffective erythropoiesis.